A caregiver survey in Beijing, Xi'an, Shanghai and Chengdu: health services status for the elderly with dementia / 中国医学科学院学报

<p><b>OBJECTIVE</b>In order to rationally allocate resources and to improve the quality of life of people with dementia, it is necessary to assess their current health services status.</p><p><b>METHODS</b>A population-based door-to-door caregiver survey was conducted in Beijing, Xi'an, Shanghai and Chengdu in 1998. Totally 1 141 individuals with dementia were found among 34 807 residents aged 55 years and over on the basis of national prevalence study of dementia. Then 428 families with demented patients were randomly selected for questionare interview. Interviews were completed in 405 but refused by 23 families. Measurements included demographic characteristics of patients and their caregivers, perspective of the victim of the disease, current awareness of the disease and medical and welfare services provided.</p><p><b>RESULTS</b>Among 405 cases of dementia (including 298 cases of AD and 81 cases of VaD), mean MMSE scores were 16.3 +/- 5.3 for 157 mild cases, 12.7 +/- 5.4 for 135 moderate cases, and 6.2 +/- 5.8 for 110 severe cases. Most patients (96%) were cared for at home by family members. Among caregivers, 189 (48.8%) considered the impairment of cognition, behavior and daily living activity in demented persons as a result of normal aging. Half of the caregivers spend over 8 hours each day looking after the patient. Whether the caregivers brought their relatives with dementia to a doctor was determined by disease severity, i.e. 8.3% for mild, 13.5% for moderate, and 19.4% for severe in 1996 to approximately 1997 and 14.4%, 25.6% and 33.6%, respectively in 1998-1999. Of those, only 26.9% reported receiving a dementia diagnosis, and only 21.3% received a recommedation to take medication. However, there was no established standard treatment and only 2% patient's used Ache-I.</p><p><b>CONCLUSIONS</b>General education is needed to increase the public awareness of dementia. For patients with dementia, early diagnosis, early treatment and optimal care are important to improve their quality of life.</p>

Analysis on association between the polymorphisms in apolipoprotein E, interleukin-1 alpha genes and Alzheimer's disease in Chengdu area / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the correlation between the polymorphisms of apolipoprotein E(APOE), the interleukin-1 alpha (IL-1 alpha ) genes and the susceptibility to Alzheimer's disease(AD).</p><p><b>METHODS</b>Association study was performed in 114 AD patients and 113 healthy elderly individuals from Chengdu, China. Polymorphisms of APOE and IL-1 alpha genes were analyzed with polymerase chain reaction-restriction fragment length polymorphism.</p><p><b>RESULTS</b>The frequency of APOE-epsilon 4-carrying genotype in moderate to severe AD patients (28.6%) was higher than that of mild patients (18.5%) and the controls (14.2%), and the difference between moderate to severe AD group and the control group was significant (OR=2.4, 95%CI: 1.1-5.5). The frequency of epsilon 4 was also of significant difference between the group of moderate to severe dementia and the control group (OR=2.6, 95%CI: 1.3-5.3). However, no significant difference in distribution of IL-1 alpha polymorphism between AD patients and controls was observed.</p><p><b>CONCLUSION</b>The APOE epsilon 4 allele was associated with moderate to severe AD while no association between the IL-1 alpha gene polymorphism and AD was found.</p>

The prevalence of mild cognitive impairment among residents aged 55 or over in Chengdu area / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the prevalence of mild cognitive impairment (MCI) in the urban and the rural areas in Chengdu, Southwest China.</p><p><b>METHODS</b>Residents aged 55 or over were selected by stratified random cluster sampling from 19 districts, cities, and counties of Chengdu area in Sichuan province. A two-stage survey was carried out. In the first stage, CMMSE, CES-D were used as screening instruments. In the second stage, Diagnostic questionnaires of dementia and CDR were used as diagnostic instruments. The diagnostic criteria of mild cognitive impairment adopted from Petersen's were: (1) memory complaint; (2) normal activities of daily living; (3) normal general cognitive function; (4) memory impairment incompatible with age; (5) not demented; (6) CDR = 0.5 and (7) exclusion of the reversible cognitive impairment caused by other factors (i.e. depression).</p><p><b>RESULTS</b>Three thousand, nine hundred and ten subjects were examined. The prevalence rates of MCI was 2.4%. The MCI prevalence rates in the urban and the rural areas were 1.5%, 2.5% respectively, without significant difference. The MCI prevalence in males and females were 1.8%, 2.9% respectively. Prevalence rate in female was higher than in males with significant difference. Prevalence of illiteracy (4.0%) was the highest among different educational levels. The accumulated prevalence increased with age.</p><p><b>CONCLUSION</b>The prevalence of MCI (2.4%) was slightly higher than the prevalence of AD (2.05%) in the same areas of Chengdu. MCI seemed to be a high risk factor for AD which should to be followed up. Early intervention in MCI might be helpful in the prevention of AD.</p>